Journal of reconstructive microsurgery
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J Reconstr Microsurg · Jul 2004
Impact of epineurial excision of the distal recipient nerve in terminolateral neurorrhaphy.
Different surgical modifications were studied to improve success in terminolateral neurorrhaphy. The authors evaluated the efficacy of distal epineurial excision of the recipient nerve stump. Forty male Wistar rats were evaluated in four groups. ⋯ No important donor-nerve injury was detected. Axonal regeneration and functional results were better in Group 4 compared to Groups 2 and 3. An increased donor and recipient nerve contact surface area with the excision of the epineurium from the distal peroneal nerve stump (Group 4) might provide superior results with longer follow-up periods.
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J Reconstr Microsurg · Feb 2004
ReviewRadiation-induced brachial plexopathy: review. Complication without a cure.
Radiation-induced brachial plexopathy, especially the chronic and progressive form, has become an increasingly rare entity in patients receiving radiation therapy to the chest wall and axilla. However, for the patients affected by this pathologic process, the chronic pain, decline in function, and absence of a satisfactory treatment are a continuing challenge to the reconstructive peripheral nerve surgeon. The authors have undertaken a review of the relevant literature addressing radiation-induced brachial plexopathy, and here present a summary of the current understanding of the pathophysiology, diagnosis, and treatment of this disorder.
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J Reconstr Microsurg · Feb 2004
Combined application of human amniotic membrane wrapping and hyaluronic acid injection in epineurectomized rat sciatic nerve.
The purpose of this study was to investigate the effects of combined application of human amniotic membrane wrapping and hyaluronic acid injection on peripheral nerve scarring in an adult rat model. After circumferential epineurectomies of right sciatic nerves were performed in each of 72 rats, nerves were randomly divided into three groups: (1) nothing was done additional to epineurectomy; (2) the epineurectomized segment was wrapped with human amniotic membrane; and (3) the epineurectomized segment was wrapped with human amniotic membrane and hyaluronic acid was injected inside. ⋯ The least adhesion and perineurial scar tissue were observed in nerves treated with human amniotic membrane wrapping and hyaluronic acid injection. This combination appears to be safe and effective in preventing perineurial scar formation after peripheral nerve surgery in rats.
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J Reconstr Microsurg · Aug 2003
Comparative StudyFree radical-induced damage in experimental peripheral nerve injection injury.
Peripheral nerve injury secondary to injection of therapeutic agents is well-documented. Until recently, the precise mechanism of injury has been obscure; even today, the treatment of these nerve injection injuries remains controversial. The aim of this study was to determine the involvement of ischemia-reperfusion injury in the development of peripheral nerve injection injury. ⋯ Injection of lidocaine and phenol resulted in near-normal walking tracks at 8 and 12 weeks, respectively, while saline injection caused only transient impairment in walking tracks. These findings indicate that reactive oxygen species are involved in the pathogenesis of experimental peripheral nerve injection injury. Indices of free oxygen radical damage correlate with the progression of functional alterations after nerve injection injury.
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J Reconstr Microsurg · Jul 2002
Case ReportsSimultaneous three-flap reconstruction of extensive hand and finger degloving injury: case report.
Connecting the two areas of the hand and digits are the interdigital web spaces that serve as a transition zone and maintain a specific shape and architecture that facilitates the unique patterns of human prehension. In reconstructing a degloving injury that involves the fingers, hand, and interdigital webs, consideration must be given to the function of each of these three regions. The authors present a case report illustrating their management of an extensive degloving injury of the hand and fingers.